Microsoft word - nuclear_scheduling-revised-11_3.doc

Nuclear Scheduling
Bone Scans:
- Patient should be well hydrated prior to scan and able to lie flat on back
- Will need any additional reports from related studies (CT, MRI, Xray, prior nuclear bone scans) *Please ask physician staff when they call to schedule. o 15 minute IV injection o (3 hour wait time) o 30 minute delayed imaging o 15 minutes extra for each additional body part to be imaged.**Please check order, indications, etc. o 15 minute IV injection o (3 hour wait time) o 1 hour delayed imaging o 30 minutes for each additional body part to be imaged. o Any study ordered for Spine, vertebra, thoracic, cervical, lumbar spine, back pain, etc. will need a SPECT (even if it is not specifically ordered). o Any study ordered for Metastasis or cancer related may need SPECT. Case by case basis. **Please call if any question as to time needed. - 3-phase bone scan for Extremities (hands/feet) o 15 min IV injection
o (4 hour wait time)
o 30 min delayed imaging

Parathyroid Scans:
- Will need blood work if available (Intact PTH levels, Calcium levels if
- Will need any additional reports from related studies (Ultrasound, CT) - Please ask patient to bring medication list. o Patient should be off all calcium medications, thyroid medication for 5 days, and should not receive iodinated contrast within 7 days
of study. **Same prep as thyroid scans**
- Patient should be able to lie on back for at least 30 minutes. - 1 hour injection (flow, 10 minute wait time, planar imaging, SPECT - (2 hour wait time) - 30 minute delayed imaging
Hepatobiliary (HIDA) Scans:
- Will need blood work if available.
- Will need any additional reports from related studies (Ultrasound, CT,
- Please ask patient to bring medication list. o Patient should be off all Opiate, narcotic pain medications 12 hrs
prior (or 4 half –lives of medication):
 Oxycodone (Percodan, Percocet, Roxicodone, Tylox, Oxycontin  Hydrocodone (Lorcet, Vicodin, Zydone)  Codeine (Tylenol 3, Fiorinal or with codeine)  Fioricet with codeine  Demerol (Meperadine)  Darvon, Darvon-N  Wygesic (propoxyphine)  Durageis, Actiq (Fentanyl)  MS Contin (Morphine)  Dilaudid® (Hydromorphone)  Dolophine® (Methadone)  Lortab® (hydrocodone)  Phenaphen® with Codeine 3  Stadol® (Butophanol)  Talacen®  Talwin NX® (Pentazocin)  Ultram® (Tramadol)  - Patient should be NPO 6-14 hours prior to scan (but no longer than 24 - Please explain to patient that the scan will be a minimum of 2 hours. - 15 minute injection - 1 hour imaging of gallbladder filling - 30 minutes imaging of gallbladder ejection - 30 minutes additional for gallbladder that is slow to fill/empty. - Total time: 2:15
Gastric Emptying Study:
- Will need any additional reports from related studies (endoscopy, CT)
- Please ask patient to bring medication list.
o Patient should be off all Opiate pain medications 12 hrs prior (or
4 half –lives of medication):
 Oxycodone (Percodan, Percocet, Roxicodone, Tylox, Oxycontin  Hydrocodone (Lorcet, Vicodin, Zydone)  Codeine (Tylenol 3, Fiorinal or with codeine)  Fioricet with codeine  Demerol (Meperadine)  Darvon, Darvon-N  Wygesic (propoxyphine)  Durageis, Actiq (Fentanyl)  MS Contin (Morphine)  Dilaudid®  Dolophine® (Methadone)  Lortab® (hydrocodone)  Phenaphen® with Codeine 3  Stadol® (Butophanol)  Talacen®  Talwin NX® (Pentazocin)  Ultram® (Tramadol)  o Patient should be off all sedatives 12 hours prior to study:
• Diazepam • Lorazepam • Alprazolam • Midazolam • Benzodiazepines • Temazepam • Triazolam • Clonazepam • Chloral hydrate Patient should be off Reglan ® (Metoclopramide), tegaserod, domperidone,
and erythromycin, for 48 hrs prior.
Patient should be off H2blockers and Proton Pump Inhibitors for 48
hours prior to study if possible (unless referring MD specifically wants to
do study on meds):
 Ranitidine (Zantac)  Cimetidine (Tagamet)  Famotidine (Pepcid)  Nizatidine (Axid)  Omeprazole (brand names: Losec, Prilosec, Zegerid, ocid, Lomac,  Lansoprazole (brand names: Prevacid, Zoton, Monolitum, Inhibitol,  Dexlansoprazole (brand name: Kapidex, Dexilant)  Esomeprazole (brand names: Nexium, Esotrex)  Pantoprazole (brand names: Protonix, Somac, Pantoloc, Pantozol,  Rabeprazole (brand names: Zechin, Rabecid,Nzole-D, AcipHex, Pariet, Rabeloc. Dorafem: combination with domperidone. - Patient is to be NPO 4-12 hours prior to study.
- Please explain to patient length of study.
- Patient should be able to lie on back for 90 minutes.
- 90 minute protocol
o 30 minute dosing appointment, then 15 minute imaging every hour  Ex: 8:00-8:30; 9:00-9:15; 10:00-10:15; 11:00-11:15; 12:00- ** Please ask if not sure on which protocol! Thanks!
Thyroid Uptake and Scan:
- NPO 2HRS BEFORE EXAM AND 2 HRS AFTER.
- Will need blood work (Free T4, TSH specifically) from referring
- Will need any additional reports from related studies (Ultrasound, CT)
- Patient should be able to lie on back for 30 minutes.
- Please ask patient to bring medication list.
o See list of medications that should be held prior to study and
schedule accordingly.

- 15 minute dosing for pill
- (6 hour wait time)
- 15 minute imaging
- (patient to return 24 hours from dosing of pill)
- 30 minute imaging
Hold for 1 week:
***Multivitamins (have pt look on back of bottle)
• Many contain iodine.
• Fludorcortisone (Florinef) • Prednisone (Deltasone) • Hydrocortisone (Cortisol) • Betamethasone (Valisone) • Hydrocortisone (Cortaid) • Triamcinolone acetate (Kenalog, Flutex) • Fluocinolone (Lidex) Amiodarone (Cordarone, Pacerone) Bromides • Spiriva (Tiotropium Bromide) • ipratropium bromide inhaler • Cantil (Mepenzolate Bromide) • Vecuronium Bromide • Neostigmine Bromide • Pipecuronium Bromide Butazolidin (phenylbutazone) Mercurials (Diuretics-Lasix/Furosemide) Methimazole (Tapazole) Nitrates • Dilatrate-SR (isosorbide dinitrate) • IMDUR (isosorbide mononitrate) • ISMO (isosorbide mononitrate) • Isordil (isosorbide dinitrate) • Monoket (isosorbide mononitrate) • Nitro-Dur (nitroglycerin) • Nitrogard (nitroglycerin) • Nitrolingual (nitroglycerin) • Nitrostat (nitroglycerin) • Sorbitrate (isosorbide dinitrate) • Transderm-Nitro (nitroglycerin) Potassium Perchlorate- (Potassium Chlorate (VII), perchloric acid, potassium salt, peroidin, and KClO4) Propylthiouracil (PTU) Large doses of aspirin Sulfa drugs • hydrochlorothiazide • metolazone • indapamide • furosemide • bumetanide • torsemide • sulfonylureas (glipizide, glyburide, among others) • Celecoxib • acetazolamide • Sulfasalazine • Sulfathiazole • Sulfadiazine • Sulfamethazine • Trisulfapyrimidine Thiocyanate (Rhodanide)
Hold longer than 1 week:
Lugols or SSKI (hold 2 weeks)
Kelp, shellfish (2 weeks)
Synthroid (hold 3 weeks)- (Levothyroxine, Eltroxin, Levothroid, Levoxyl, Synthroid,
Unithroid)
Proloid (hold 3 weeks)
• Cytomel (Liothyronine) • Euthroid • Levoid • Levothroid • Thyrolar IV iodinated contrast for CT (hold 1-2 months) Oil-based iodinated CT contrast agents (hold 3 to 6 months)

Source: http://primemri.com/wp-content/uploads/2012/07/Nuclear-Preperations.pdf